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- cross-posted to:
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I can blame the parent for bad parenting and call myself informed and everyone else should be … because I know about bats carrying rabies
But I also know that most people have no clue that any of this can happen … it’s the first case of someone dying from rabies in Ontario from an infection that originated in Ontario since 1967 … people have no clue that this is even possible in this day in age
https://www.cbc.ca/news/canada/hamilton/rabies-death-1.7341335
About eight or ten years ago I woke up one night in my cottage to a bat flying around my place. It was dark inside and I saw this thing fluttering around in my room. I opened a window and let it out and never thought anything of it. About a year later, I happened to be reading some stuff about rabies … the hair in the back of my neck went up and it’s freaked me out since.
After that bat in my room, I never went for treatment, I never got checked out and I never thought anything of it. It’s been about ten years and I keep worrying that some day I’ll start feeling the effects of it. I think most people in Ontario would do the same because everyone thinks we got rid of rabies decades ago or that it is a third world disease that isn’t possible here.
I feel terrible for that parent … death from rabies is a horrible way to die and it happened to this child with their parents watching it all happen.
I wouldn’t wish that on my worst enemy … let alone someone I would accuse of bad parenting.
Quick heads up that we do have effective treatments UNTIL you start exhibiting symptoms, after that you can’t really be cured anymore and would just have to live with it (and manage the symptoms until it kills you shortly after)
I can blame the parent for bad parenting and call myself informed and everyone else should be … because I know about bats carrying rabies
Most provinces and the federal’s health protocols no longer recommend automatic treatment for “bat in room” situations. Only if there’s reasonable doubt of having been bitten. I’ve been there and I really had to advocate to the ER doctor that there was no way for me to know.
The CDC guidelines are a bit confusing too, like is just being in a house common behavior, as in the part about keeping bats out, or a sign of rabies as in an earlier part? Should you check for physical contact or just go get tested? (And in the US, will your insurance cover the test without symptoms showing?) Should you get the fucking plague beast out of your house while avoiding contact, or try to catch it for testing?
I thought by the time it is detectable in tests on a person, that person is already terminal. My understanding is if you have any chance of exposure from an animal you skip the tests and go get the shots. IDK about insurance.
Get shots, pay health insurance. Dont get shots, life insurance pays your loved ones.
Macabre and sadly true.
Or be in Canada and just get shots to be safe. It’s $250 as a precautionary shot before travel but if you have suspected exposure it will be free.
My life insurance pays a hell of a lot better than my health insurance does.
I agree and I was just being cynical about health insurance companies denying care for cruelly stupid reasons. Although I remember some old TV shows where “if the animal can be quickly caught and it tests negative for rabies, the child won’t have to undergo the painful series of abdominal shots.” Not sure if the treatment is still as miserable as portrayed.
Horrible. Understandable that a parent may not know the risk involved.
Only reason I know was when I worked at a summer camp they hammered into us that if a bat was found in a cabin we had to catch it for testing, or else everyone staying in that cabin would get rabies shots.
I assume we would be ok if it didn’t bite us?
Edit: no get tested. Apparently they attack when humans are sleeping and can leave no trace.
Yeah, state of the art may have changed since then, but since you can’t see the bite and a test on a human wouldn’t show anything until it’s too late, the options were either have a lab test the bat or get precautionary rabies shots.
I try not to judge, but I’m also utterly confused as to why the parents wouldn’t immediately have brought the child in for the shot after finding the bat, visible bite or not…
To tell the truth I wouldn’t have thought about it. A stray deranged dog or racoon would raise alarm bells, but we set bats here at night always, and didn’t consider the risk. Oops
No scratches, no bite. Why would they?
Bats have tiny teeth and it’s possible to be bitten without there being any visible mark. You should always go for treatment if you have had an interaction with a bat. Better safe than dying one of the worst ways possible.
Most commonly they bite you while you’re sleeping, so you don’t know
My thinking would be why risk not getting checked out? Unfortunately worst case scenario happened this time :(
The indication for testing according the CDC is a bite.
The rabies test is cheap. Could have tested the kid or the bat, but again why would they do it if there’s no indication for exposure. This was the first case in the province of someone being infected with rabies inside their own home since 1967.
When you hear hoofbeats you don’t think it’s zebras.
You can’t test the kid, only the bat. So if they didn’t catch it testing is a no go.
There’s like eleven kinds of blood tests for rabies. None of them work on people, or is it by the time they work it’s too late?
By the time it’s detectable it’s too late.
Okay that’s sort of what I thought.
So the protocol, from like an insurance coverage decision-tree standpoint, in this situation, would have been to test the bat if possible and if not possible administer the vaccine?
I was under the impression that the vaccine is pretty awful and a health ordeal in itself, and that while the dose wasn’t expensive, the aftercare is.
And that is why, as I understand, the CDC protocol is only seek medical attention if there’s a visible bite.
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As soon as a rabies test comes back positive, you have a death sentence.
How do you think the child got rabies in this situation?
Obviously they overlooked a scratch or a bite. Rabies isn’t airborne.
This you?
No scratches, no bite. Why would they?
What do you mean? Yes. They checked the kid over and saw nothing. Obviously there was an exposure that either left no mark, left a mark that appeared normal, or the parents didn’t see it.
Maybe it drooled into their open mouth or something. Or onto their hand and later they picked their nose.
Sounds possible. Bats are mammals, maybe it sneezed, covered, but didn’t wash it’s hands, gave the kid a high five, and then the kid wiped a booger out of his eye with it.
Poor kid, never had a chance.
Heartbreaking
That’s literally the health institutions protocol now a days. Though for kids it depends how credible the kid is about not being exposed.
I looked at the CDC website before posting Aunt. It says the only indication for treatment is a bite or a scratch from species known to carry rabies. It doesn’t say anything about testing for mere exposure.
I guess I see the counterpoints.
It’s a kid. The duration of the exposure is unknown. Whether there was any contact is unknown. Bat. Bites or scratches can be invisible. Bires or scratches could be mistaken.
What’s the scuttlebutt here, your saying in this situation to test the kid or administer a vaccine?
I’m certain the medical staff 's determination of The credibility of a fact attested to by a child is not a factor.
We’re also assuming this kid isn’t a straight up victim of healthcare inequality. The article is light on details. Perhaps the parents considered this, searched the web, searched for bites or scratches, and the cost of seeking care felt too great for this family? I didn’t catch if this happened in a civilized nation with universal health.
Fuck, this story is terrifying. Reminds me in some ways of when a kid dies in a hot car.
You can’t test the kid. What I’m saying is a lot of people in here are quick to judge the parents, but clearly even to medical professionals the situation is not cut and dry.
As I mentioned in another comment, I’ve been there. I have been through PPE, and I had to seriously advocate for myself to the ER doctor for him to go consult an infectious disease specialist before they agreed.
Health Canada guidance is a bit more nuanced
Post-exposure prophylaxis or testing of a bat is generally recommended after direct contact with the bat (refer to Bat Exposure) because it is very difficult to ensure that a bite did not take place
Bat exposure: Post-exposure rabies prophylaxis following bat contact is recommended when both of the following conditions apply:
- There has been direct contact with a bat, AND
- A bite, scratch, or saliva exposure into a wound or mucous membrane cannot be ruled out.
Direct contact with a bat is defined as a bat touching or landing on a person.
In a child, a bat landing on clothing could be considered a reason for intervention, as a history to rule out a bite, scratch or mucous membrane exposure may not be reliable.
From 1998 to 2009, NACI recommended that people who may not be aware of or able to report a bat bite (e.g., sleeping person, young child, cognitively impaired) be offered intervention if a bat was found in the room with them. This recommendation was revised (as described above) in 2009 based on the rarity of human rabies related to bats (one case in Canada reported approximately every 5 years). Analysis conducted in Canada estimated that a case of human rabies related to bedroom exposure to a bat (i.e., finding a bat in the room of a sleeping person with no recognized physical contact with the bat) is expected to occur in Canada once every 84 years. In addition, it has been determined that, to prevent one case of rabies from bedroom exposure to a bat, using a conservative estimate, 314,000 people would need to be treated.
Based on all the comments in this thread, this seems like the best course to me.
Honestly, I didn’t know much about this and didn’t have a strong opinion from the beginning. I just looked quick on Google and saw the results for America was to only seek treatment if there’s been a confirmed bite or scratch.
This Canadian advice makes way more sense. I like that last paragraph that explains the protocol from 1998 to 2009 would have required treatment of 314,000 people to prevent one case. This poor kid in the article might have been that one case.
But it seems like under the current recommendations the kid would not have been tested. It says now treatment only only after direct contact, defined as a bat touching or landing on a person. In this situation, I think they didn’t know if the bat had touched the kid at all.
I try not to judge, but I am going to make an exception in this case.
Bad parents plain and simple. That child deserved better.
Some people aren’t educated in these things.
Some people aren’t educated in these things.
Tell that to the dead child who deserved better than ignorant parents that didn’t even care enough to do a Google search.
Ignorance is not an excuse.
It isn’t protocol for the hospitals to give the shot for a bat in the room. Probably would have gone to the hospital and been turned away.
And it’s easy after the fact to say oh should have done this. As they say hindsight is 20/20.Yeah, the takeaway from this is, “We need some public service announcements about bats,” and “The healthcare protocol needs to be updated so that a shot is given if a bat is found in a room where someone was asleep or otherwise may have been bitten without being conscious of it,” not “These are bad parents.”
It isn’t protocol for the hospitals to give the shot for a bat in the room. Probably would have gone to the hospital and been turned away.
Or they would have gone to the hospital and had the Doctor find the bite/scratch that led to the rabies infection.
And it’s easy after the fact to say oh should have done this. As they say hindsight is 20/20.
Would you be saying this if the child was left in a hot car? Unattended in the bath? Found unsecured chemicals under the sink?
As I said, ignorance is no excuse for a dead child.
You’re obviously not a parent. Downvoted and blocked.
Oh no! Don’t down vote and block me! Please! Anything but that!
Ignorance is not an excuse.
If no one has ever told them that some bats carry rabies how would they know to Google anything when they find a bat in the house? It’s not something that is taught in school and I’ve never seen or heard a PSA talking about it in Ontario.
If no one ever told them the dangers of hot cars, would you be arguing this if the child died in one? If no one ever told them to not leave a child unattended in the bath, would you be arguing this when the child drowned? If no one ever told them to properly secure chemicals, and the child drinks them would you still be arguing for ignorance?
Lots of things aren’t taught in schools. Many don’t have wide reaching PSA’s.
None of that changes the fact that a child died from a very preventable illness because the parents didn’t think.
Ignorance is not an excuse for a dead child.
Little known fact groundhogs are also rabies vectors
He just popped out, saw his shadow, pulled out a switchblade, and then started running straight towards us
Only a handful of people (20ish) have ever survived without getting an antiviral shot before symptoms presented.
And it’s a pretty horrific way to die (absolutely dehydrated and needing fluid but gagging and choking if offered a drink).
If I ever got it I’d want to be put in a coma while my immune system tried to knock it out and euthanized if I didn’t recover reasonably.
When I was young the fear was put into us by my parents. The Cugo movie really reinforced it.
A lot of people have a lot of strong opinions around here so, as someone who’s been in a bat in room situation with ambiguous contact potential let me point you to Quebec’s Health Ministry’s Post Exposition Prophylaxis guidelines:
Vacciner les personnes ayant eu une exposition significative à une source potentiellement rabique.
Une exposition significative est une morsure, une griffure ou un contact de la salive ou du LCR d’un mammifère potentiellement rabique avec une plaie fraîche (ayant saigné ou suinté depuis moins de 24 heures) ou avec une muqueuse.
L’exposition significative se définit comme suit :
Chauve‑souris : présence des 2 conditions suivantes :
Contact physique reconnu avec la chauve‑souris; Morsure, griffure ou contact de la salive de la chauve‑souris avec une plaie fraîche (ayant saigné ou suinté depuis moins de 24 heures) ou avec une muqueuse non exclu. La PPE n’est pas indiquée en l’absence de contact physique reconnu (ex. : chauve‑souris trouvée dans la maison sans qu’on ait eu connaissance d’un contact physique avec l’animal). Si la description des faits ne peut être obtenue auprès d’une personne fiable (ex. : jeune enfant ou personne intoxiquée), il faut chercher à savoir si des éléments de l’histoire laissent croire à un tel contact, comme des cris ou des pleurs soudains ou inhabituels ou bien une lésion cutanée compatible avec une morsure de chauve‑souris (plaie punctiforme comparable à la piqûre d’une aiguille hypodermique, d’un diamètre inférieur ou égal à 1 mm, peu ou pas douloureuse).
https://www.msss.gouv.qc.ca/professionnels/vaccination/piq-vaccins/rage-vaccin-contre-la-rage/
Translation of the bold section: PPE is not indicated in the absence of known physical contact (ex: a bat found in the house without knowledge of physical contact).
See also this triage chart:
https://www.msss.gouv.qc.ca/aide-decision-app/accueil.php?situation=Rage
Pardon my slight tangent, but I was under the assumption that French to English machine translations got a leg up compared to other language pairs specifically because the Canadian government tirelessly translates and releases all of its information in both languages. All this to say, shouldn’t this be available in English too?
The Federal government publishes everything in both languages, but the Quebec government probably doesn’t
Can’t use machine translation for medical and legal documentation for obvious reasons.
Sorry, I meant the developers of machine translation tools took the readily available mountain of manually translated texts from the Canadian government to ‘train’ their tools.
Aaaaaah well this document is from the provincial ministry. I’m sure very similar ones exist in English from other provinces, but I knew where that one was, for reasons previously explained.